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Westman, Göran
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Publications (10 of 31) Show all publications
Nilsson, M., Rasmark, U., Nordgren, H., Hallberg, P., Skönevik, J., Westman, G. & Rolandsson, O. (2009). The physician at a distance: the use of videoconferencing in the treatment of patients with hypertension. Journal of Telemedicine and Telecare, 15(8), 397-403
Open this publication in new window or tab >>The physician at a distance: the use of videoconferencing in the treatment of patients with hypertension
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2009 (English)In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 15, no 8, p. 397-403Article in journal (Refereed) Published
Abstract [en]

We evaluated the feasibility and quality of uncomplicated hypertension care based on telemedicine in a rural area of northern Sweden. The intervention subjects were 91 consecutive patients with primary hypertension. For comparison, 182 age- and sex-matched patients with hypertension were randomly selected from a similar health centre. The telemedicine equipment consisted of a video link between the physician and the patients, supported by a system for accessing medical data via the Internet. During a 21-month study period, telemedicine was used in 270 (91%) of the 297 consultations in the intervention group. All health personnel involved in the telemedicine treatment rated the method as feasible. Both systolic and diastolic blood pressure improved in the two groups during the study period. In the intervention group, a higher proportion had their blood pressure within treatment goals (systolic blood pressure <140 mmHg, diastolic blood pressure <90 mmHg) both at baseline and at follow-up than in the comparison group. An adjusted multivariate model (adjustment for sex, age, time between visits, change in number of drugs between first and last visit, blood pressure at first visit) showed that the intervention group had a higher probability (OR 2.7, 95% CI 1.4-5.2) of reaching the target blood pressure levels than the reference group. Treatment of hypertension by means of telemedicine was quite feasible and at least as effective as face-to-face consultations with a physician.

Place, publisher, year, edition, pages
Sage Publications, 2009
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-35295 (URN)10.1258/jtt.2009.090509 (DOI)19948706 (PubMedID)
Available from: 2010-08-11 Created: 2010-08-11 Last updated: 2018-06-08Bibliographically approved
Westman, G. (2008). Att disputera: ofta början på något nytt. In: Forskarhandledares robusta råd. (pp. 69-82). Lund: Studentlitteratur
Open this publication in new window or tab >>Att disputera: ofta början på något nytt
2008 (Swedish)In: Forskarhandledares robusta råd., Lund: Studentlitteratur , 2008, p. 69-82Chapter in book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Lund: Studentlitteratur, 2008
Identifiers
urn:nbn:se:umu:diva-18815 (URN)9789144029993 (ISBN)
Available from: 2009-05-19 Created: 2009-02-25 Last updated: 2018-06-08
Risberg, G., Johansson, E., Westman, G. & Hamberg, K. (2008). Attitudes toward and experiences of gender issues among physician teachers: a survey study conducted at a university teaching hospital in Sweden. BMC Medical Education, 8, Article ID 10.
Open this publication in new window or tab >>Attitudes toward and experiences of gender issues among physician teachers: a survey study conducted at a university teaching hospital in Sweden
2008 (English)In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 8, article id 10Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Gender issues are important to address during medical education, however research about the implementation of gender in medical curricula reports that there are obstacles. The aim of this study was to explore physician teachers' attitudes to gender issues.

METHODS: As part of a questionnaire, physician teachers at Umeå University in Sweden were given open-ended questions about explanations for and asked to write examples why they found gender important or not. The 1 469 comments from the 243 respondents (78 women, 165 men) were analyzed by way of content analysis. The proportion of comments made by men and women in each category was compared.

RESULTS: We found three themes in our analysis: Understandings of gender, problems connected with gender and approaches to gender. Gender was associated with differences between women and men regarding behaviour and disease, as well as with inequality of life conditions. Problems connected with gender included: delicate situations involving investigations of intimate body parts or sexual attraction, different expectations on male and female physicians and students, and difficulty fully understanding the experience of people of the opposite sex. The three approaches to gender that appeared in the comments were: 1) avoidance, implying that the importance of gender in professional relationships was recognized but minimized by comparing gender with aspects, such as personality and neutrality; 2) simplification, implying that gender related problems were easy to address, or already solved; and 3) awareness, implying that the respondent was interested in gender issues or had some insights in research about gender. Only a few individuals described gender as an area of competence and knowledge. There were comments from men and women in all categories, but there were differences in the relative weight for some categories. For example, recognizing gender inequities was more pronounced in the comments from women and avoidance more common in comments from men.

CONCLUSION: The surveyed physician teachers gave many examples of gender-related problems in medical work and education, but comments describing gender as an area of competence and knowledge were few. Approaches to gender characterized by avoidance and simplification suggest that faculty development programs on gender need to address and reflect on attitudes as well as knowledge.

Place, publisher, year, edition, pages
BioMed Central, 2008
Keywords
Adult, Faculty, Medical, Female, Gender Identity, Health Knowledge, Attitudes, Practice, Hospitals, Teaching, Humans, Interprofessional Relations, Male, Middle Aged, Physicians/*psychology, Physicians, Women/*psychology, Prejudice, Students, Medical/*psychology, Sweden, Women's Rights
National Category
General Practice Gender Studies
Identifiers
urn:nbn:se:umu:diva-10707 (URN)10.1186/1472-6920-8-10 (DOI)000207735100010 ()18302735 (PubMedID)
Funder
Swedish Research CouncilVästerbotten County Council
Available from: 2008-10-23 Created: 2008-10-23 Last updated: 2019-03-06Bibliographically approved
Lundberg, T., Westman, G., Hellström, S. & Sandström, H. (2008). Digital imaging and telemedicine as a tool for studying inflammatory conditions in the middle ear: evaluation of image quality and agreement between examiners. International Journal of Pediatric Otorhinolaryngology, 72(1), 73-79
Open this publication in new window or tab >>Digital imaging and telemedicine as a tool for studying inflammatory conditions in the middle ear: evaluation of image quality and agreement between examiners
2008 (English)In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 72, no 1, p. 73-79Article in journal (Other academic) Published
Abstract [en]

Objective: To evaluate digital imaging of the tympanic membrane by telemedicine technology and study interpersonal agreement in assessing image quality.

Methods: In an open consecutive study, 64 children aged 2-16 years who attended three rural health care centres in Northern Sweden with otalgia were examined with video endoscopic photography of their tympanic membrane in a telemedical environment. One hundred and twenty-four images were stored in a central database and Later assessed independently regarding image quality by an ENT specialist, a general practitioner and a registrar in general practice. The overall image quality was graded (0-2) regarding assessment of signs of tympanic membrane inflammation. ALL images were also assessed regarding 8 different components, four image-related components and four anatomically related components.

Results: Overall image quality was good, with 82.3% of acceptable or excellent quality. The position and thickness of the TM were found to be the most important factors of the images to be able to assess inflammatory disease. Image quality tended to be higher later in the study as a sign of improved skills of examiners. Interpersonal agreement between examiners was acceptable. Overall grade showed k 0.56, 0.49 and 0.66 respectively, and focus, light and existence of obscuring objects were the components with the highest agreement.

Conclusions: The image quality of video endoscopy of the tympanic membrane was good overall. Interpersonal agreement in evaluating image quality was acceptable but not excellent. The use of digital imaging of good quality in clinical studies can offer an objective clinical evaluation of the TM in retrospect by independent reviewers using strict criteria.

Keywords
otitis media, tympanic membrane, digital imaging, video endoscopy, telemedicine
National Category
Medical Image Processing
Identifiers
urn:nbn:se:umu:diva-10417 (URN)10.1016/j.ijporl.2007.09.015 (DOI)000253035100012 ()17983668 (PubMedID)
Available from: 2008-09-08 Created: 2008-09-08 Last updated: 2018-06-09Bibliographically approved
Hendrikx, T., Nilsson, M. & Westman, G. (2008). Sense of coherence in three cross-sectional studies in Northern Sweden 1994, 1999 and 2004: patterns among men and women. Scandinavian Journal of Public Health, 36(4), 340-345
Open this publication in new window or tab >>Sense of coherence in three cross-sectional studies in Northern Sweden 1994, 1999 and 2004: patterns among men and women
2008 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 36, no 4, p. 340-345Article in journal (Refereed) Published
Abstract [en]

Aims: To explore changes in sense of coherence (SOC) over a 10-year period in the general population in northern Sweden.

Methods: Three cross-sectional surveys from 1994 (n=1802), 1999 (n=1698) and 2004 (n=1777), conducted within the northern Sweden MONICA Project, were compared. Participants answered questions about gender, age, experience of disease, perceived health, psychosocial factors and Antonovsky's SOC scale with 13 items.

Results: A small, but significant, decrease in SOC medians and a shift of cumulative distributions towards slightly lower SOC values were seen both in the total study population and in its male and female subgroups between 1994 and 1999. No changes were seen between 1999 and 2004, with the exception of women between 25 and 44 years of age, who showed a continuous decrease.

Conclusions: The present study shows that SOC at a population level in northern Sweden, within a 10-year span, is relatively stable, not withstanding minor changes. These small changes might be attributed to societal changes in Sweden during the 1990s and an increase in "minor'' psychiatric complaints in the Swedish population as a whole during the same period.

Place, publisher, year, edition, pages
Oslo: Taylor & Francis, 2008
Keywords
gender, general population, sense of coherence, WHO MONICA project
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-117496 (URN)10.1177/1403494808089560 (DOI)000257536300002 ()18539687 (PubMedID)
Available from: 2016-03-03 Created: 2016-03-01 Last updated: 2018-06-07Bibliographically approved
Gustafsson-Larsson, S., Thurén, B.-M., Dahlgren, L. & Westman, G. (2007). Bun-baking mums and subverters: The agency of network participants in a Rural Swedish county. Women´s Studies International Forum, 30, 48-58
Open this publication in new window or tab >>Bun-baking mums and subverters: The agency of network participants in a Rural Swedish county
2007 (English)In: Women´s Studies International Forum, Vol. 30, p. 48-58Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-16069 (URN)
Available from: 2007-08-27 Created: 2007-08-27 Last updated: 2018-06-09Bibliographically approved
Christianson, M., Lalos, A., Westman, G. & Johansson, E. (2007). "Eyes wide shut" - sexuality and risk in HIV-positive youth in Sweden: a qualitative study. Scandinavian Journal of Public Health, 35(1), 55-61
Open this publication in new window or tab >>"Eyes wide shut" - sexuality and risk in HIV-positive youth in Sweden: a qualitative study
2007 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, no 1, p. 55-61Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-5630 (URN)10.1080/14034940600812943 (DOI)17366088 (PubMedID)
Available from: 2007-01-03 Created: 2007-01-03 Last updated: 2018-06-09Bibliographically approved
Eriksson, C., Westman, G. & Hamberg, K. (2006). Content of childbirth-related fear in Swedish women and men: analysis of an open-ended question. Journal of midwifery & women's health, 51(2), 112-118
Open this publication in new window or tab >>Content of childbirth-related fear in Swedish women and men: analysis of an open-ended question
2006 (English)In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 51, no 2, p. 112-118Article in journal (Refereed) Published
Abstract [en]

The content of childbirth-related fear as described by 308 women and 194 men was analyzed and compared in relation to intensity of fear. The content of fear was similarly described by women and men and concerned the following main categories: the labor and delivery process, the health and life of the baby, the health and life of the woman, own capabilities and reactions, the partner's capabilities and reactions, and the professionals' competence and behavior. Among women, the labor and delivery process was the most frequently reported among the 6 categories of fears, whereas the health and life of the baby was the most frequent among the men. Fears related to own capabilities and reactions were described significantly more often by women with intense fear than by women with mild to moderate fear. The greatest difference between men with intense versus mild to moderate fear was a more frequent expression of concern for the health and life of the woman. Both women and men had fears related to not being treated with respect and not receiving sufficient medical care. This finding suggests that part of the problem with childbirth-related fear is located within the health care system itself.

Keywords
childbirth-related fear; fear of childbirth; contents; women and men; gender perspective
National Category
General Practice
Identifiers
urn:nbn:se:umu:diva-26282 (URN)10.1016/j.jmwh.2005.08.010 (DOI)16504908 (PubMedID)
Available from: 2009-10-05 Created: 2009-10-05 Last updated: 2018-06-08Bibliographically approved
Eriksson, C., Westman, G. & Hamberg, K. (2005). Experiential factors associated with childbirth-related fear in Swedish women and men: a population based study.. Journal of Psychosomatic Obstetrics and Gynaecology, 26(1), 63-72
Open this publication in new window or tab >>Experiential factors associated with childbirth-related fear in Swedish women and men: a population based study.
2005 (English)In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 26, no 1, p. 63-72Article in journal (Refereed) Published
Keywords
Adult, Cross-Sectional Studies, Fear, Female, Humans, Labor; Obstetric/*psychology, Male, Middle Aged, Population Surveillance, Pregnancy, Questionnaires, Sweden
Identifiers
urn:nbn:se:umu:diva-6139 (URN)15962723 (PubMedID)
Available from: 2007-12-06 Created: 2007-12-06 Last updated: 2018-06-09Bibliographically approved
Nilsson, M., Norberg, B., Hultdin, J., Sandström, H., Westman, G. & Lökk, J. (2005). Medical intelligence in Sweden. Vitamin B12: oral compared with parenteral?. Postgraduate medical journal, 81(953), 191-193
Open this publication in new window or tab >>Medical intelligence in Sweden. Vitamin B12: oral compared with parenteral?
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2005 (English)In: Postgraduate medical journal, ISSN 0032-5473, E-ISSN 1469-0756, Vol. 81, no 953, p. 191-193Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Sweden is the only country in which oral high dose vitamin B12 has gained widespread use in the treatment of deficiency states. OBJECTIVE: The aim of the study was to describe prescribing patterns and sales statistics of vitamin B12 tablets and injections in Sweden 1990-2000.Design, setting, and sources: Official statistics of cobalamin prescriptions and sales were used. RESULTS: The use of vitamin B12 increased in Sweden 1990-2000, mainly because of an increase in the use of oral high dose vitamin B12 therapy. The experience, in statistical terms a "total investigation", comprised 1,000,000 patient years for tablets and 750,000 patient years for injections. During 2000, 13% of residents aged 70 and over were treated with vitamin B12, two of three with the tablet preparation. Most patients in Sweden requiring vitamin B12 therapy have transferred from parenteral to oral high dose vitamin B12 since 1964, when the oral preparation was introduced. CONCLUSION: The findings suggest that many patients in other post-industrial societies may also be suitable for oral vitamin B12 treatment.

Keywords
Administration; Oral, Adolescent, Adult, Aged, Child, Child; Preschool, Female, Humans, Infant, Infant; Newborn, Injections; Intramuscular, Male, Middle Aged, Physician's Practice Patterns/trends, Prescriptions; Drug/statistics & numerical data, Sweden, Tablets, Vitamin B 12/*administration & dosage, Vitamin B 12 Deficiency/*drug therapy
Identifiers
urn:nbn:se:umu:diva-14819 (URN)10.1136/pgmj.2004.020057 (DOI)15749797 (PubMedID)
Available from: 2008-10-10 Created: 2008-10-10 Last updated: 2018-06-09Bibliographically approved
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